Stages of Human African Trypanosomiasis

• Early Phase:

  • Hemolyphatic Stage

  = Parasites proliferate the blood stream and lymphatics

  • Winterbottom's occurs (for T. gambiense)
  • Fever, headache, muscle pain, and heart involvement
  • Last for 1-6 months
• Late Phase:

  • Meningoencephalitic Stage
  • Involvement of the CNS
  • Manifest for 3-10 months in T. gambiense and only a few weeks for T. rhodosiense
  • Kerandel's sign
  • Somnolence (Strong desire to sleep) manifest, followed by DEEP COMA
• TREATMENT OF CHOICE:

  Dependent on the stage of the Disease

  First Stage:

  • IV or Intravenous SURAMIN SODIUM
  • IM or Intramuscular PENTAMIDINE (for Gambian)

  CNS Involvement:

  • IV or Intravenous MELARSOPROL

  = Side effect: JARISCH-HERXHEIMER reaction

  • NITROFURAZOINE (Alternative)
  • EFLORNITHINE (Less toxic than Nitrofurazoine: only for T. gambiense)